This unique national resource was made possible because of the collegial relations of the health care providers in Rochester, Minnesota, at the time. The initial medical records and the data sharing and data mining capabilities were established by the Mayo brothers as part of their pioneering idea of a group practice and their shared education mindset. Henry Plummer, M.D., Mabel Root, and Joseph Berkson, M.D., icons of Mayo Clinic history, led the development of indexable, shareable medical records that could be used both for the care of patients and for research.

In 1966, Olmsted Medical Center and Mayo Clinic formed a collaboration, and between the two groups and other smaller local providers, the REP was born.